Average Charge and Payment Data for 4 Spine/Pain Management Procedures Commonly Performed in ASCs

Here is the average 2007 Medicare sub charge (submitted charges divided by allowed services), average allow charge (Medicare-allowed charges divided by allowed services, including co-pays and deductibles paid by patient), and average payment (Medicare payments divided by allowed services, not including co-pays and deductibles paid by patient) for four spine/pain management procedures commonly performed in ASCs.

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By: Staff

1. Injection of lower back joint (HCPCS G0260)
– average sub charge: $1,290
– average allow charge $281
– average payment: $222

2. Single nerve block injection, arm nerve (CPT 64415)
– average sub charge: $1,262
– average allow charge $83
– average payment: $65

3. Multiple nerve block injections, rib nerves (CPT 64421)
– average sub charge: $1,323
– average allow charge $317
– average payment: $249

4. Injection of lower back spinal joint or nerve (CPT 64476)
– average sub charge: $1,146
– average allow charge $186
– average payment: $148

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